Cardiology clinics
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Sudden cardiac death caused by malignant ventricular arrhythmias is the most important cause of death in the industrialized world. Most of these lethal arrhythmias occur in the setting of ischemic heart disease. ⋯ Genetically induced ventricular arrhythmias can be divided in two subgroups: the primary electrical disorders or channelopathies, and the secondary arrhythmogenic cardiomyopathies. This article focuses on the genetic background of these electrical disorders and the current knowledge of genotype-phenotype interactions.
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Catheter ablation is an effective therapy for symptomatic ventricular arrhythmia (VA) in patients with and without structural heart disease. It is the treatment of choice to cure or reduce recurrent VA in patients who have an implantable cardioverter defibrillator and can be a life-saving procedure in patients who have electrical storm. Catheter ablation for VAs remains a challenging procedure and requires a precise understanding of cardiac electrophysiology, the arrhythmia mechanisms, and mapping techniques. ⋯ These techniques complement each other in localizing the critical isthmus of a reentrant VT or the source of origin of a focal VT. Most VAs can be ablated endocardially. Epicardial ablation is needed for VAs with an epicardial circuit or a focal source.